1740342187 NPI number — AURORA COMMUNITY HEALTH INC

Table of content: (NPI 1740342187)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740342187 NPI number — AURORA COMMUNITY HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AURORA COMMUNITY HEALTH INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740342187
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
406 TECHNOLOGY DR E STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MENOMONIE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54751-2768
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-235-4667
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 TECHNOLOGY DR E STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENOMONIE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54751-2768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-235-4667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WOLSKE-BAKER
Authorized Official First Name:
AVIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CAO
Authorized Official Telephone Number:
715-235-1839

Provider Taxonomy Codes

  • Taxonomy code: 374U00000X , with the licence number:  310 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 43106900 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com